ADHD: Symptoms, Diagnosis, and Neurobiological Insights

What are the three core symptoms of ADHD?

Inattention, hyperactivity, and impulsivity.

What is inattention in the context of ADHD?

Difficulty focusing on tasks or following through on instructions.

Define hyperactivity as it relates to ADHD.

Excessive movement and inability to stay still, often leading to disruptive behavior.

What does impulsivity mean in ADHD?

Acting without thinking, which can lead to risky behaviors or social issues.

What neuroimaging technique shows differences in ADHD brains?

Functional MRI (fMRI).

How was ADHD viewed in the early 1900s?

As poor inhibitory volition and defective moral control.

What term was introduced in the 1920s related to ADHD?

'Brain-injured child syndrome.'

What was the focus of ADHD research in the 1970s and 1980s?

Attention deficits and impulse control, along with the introduction of stimulant medications.

What are the two main dimensions of ADHD symptoms?

Inattention and hyperactivity-impulsivity.

What is the DSM-5-TR's role in ADHD?

It outlines specific criteria for diagnosing ADHD based on symptoms of inattention and hyperactivity-impulsivity.

What is a limitation of the DSM-5-TR criteria for ADHD?

They may not fully capture the complexity of ADHD and can lag behind emerging research.

What cognitive deficits are common in children with ADHD?

Deficits in executive functions such as working memory, planning, and flexibility of thinking.

How do children with ADHD typically perform academically?

They may struggle to apply their cognitive abilities, leading to lower academic performance despite typical intelligence.

What types of learning disorders are common in children with ADHD?

Learning disorders in reading, spelling, and math.

What social challenges do children with ADHD often face?

Struggles to form friendships, often facing rejection and difficulty with social understanding.

What is the relationship between ADHD and Oppositional Defiant Disorder (ODD)?

A significant proportion of children with ADHD also meet the criteria for ODD, indicating strong comorbidity.

What genetic factor may influence the severity of ODD and CD symptoms in children with ADHD?

Variations in the catechol-o-methyltransferase gene (COMT).

What role do family dynamics play in the development of ODD and CD in children with ADHD?

Shared environmental factors, such as family adversity and parenting deficits, contribute to these disorders.

What is the impact of myths surrounding ADHD?

They contribute to stigma and misunderstanding, often linked to lack of awareness and misinformation.

What are the three types of ADHD presentations?

Predominantly Inattentive Presentation (ADHD-PI), Predominantly Hyperactive-Impulsive Presentation (ADHD-HI), and Combined Presentation (ADHD-C).

What characterizes the Predominantly Inattentive Presentation (ADHD-PI)?

Distractibility and disorganization.

What is a common characteristic of the Predominantly Hyperactive-Impulsive Presentation (ADHD-HI)?

It is rare and often seen in preschoolers.

What is the most common presentation of ADHD?

Combined Presentation (ADHD-C), which often leads to treatment referrals.

What are some common medical issues associated with ADHD?

Higher risk for enuresis, asthma, and dental health issues.

How does ADHD affect self-perception in children?

Children may have distorted self-perceptions, leading to exaggerated views of competence and fluctuating self-esteem.

What is impulsivity in ADHD characterized by?

Cognitive impulsivity (disorganization), behavioral impulsivity (difficulty inhibiting responses), and emotional impulsivity (impatience).

What can mitigate the risk of developing ODD and CD in children with ADHD?

Early intervention and supportive family environments.

What percentage of children with ADHD experience excessive anxiety?

Between 25% to 50%.

What is the prevalence of depression among children with ADHD?

Affects 20% to 30% of this population.

What are common symptoms of depression in children with ADHD?

Feelings of sadness, hopelessness, and being overwhelmed.

What therapeutic approaches are effective for ADHD and co-occurring disorders?

Cognitive-behavioral therapy (CBT) and family support.

What percentage of children with ADHD exhibit motor coordination difficulties?

30% to 50%.

What is Developmental Coordination Disorder (DCD)?

A condition characterized by marked motor incoordination and delays in achieving motor milestones, overlapping significantly with ADHD.

What percentage of children with ADHD are affected by tic disorders?

Approximately 20%.

What are common involuntary movements associated with tic disorders?

Eye blinking and throat clearing.

How does family dynamics influence conduct disorder behaviors in children with ADHD?

Family dynamics and peer relationships can contribute to rule violations and aggression.

What is the clinical referral ratio of boys to girls diagnosed with ADHD?

6:1, with boys being diagnosed more frequently.

How may girls with ADHD present symptoms differently than boys?

Girls often exhibit inattentive symptoms rather than hyperactive-impulsive ones.

What risk do girls with ADHD who display impulsive-hyperactive behaviors face?

A higher risk of developing eating disorders.

How does socioeconomic status relate to the prevalence of ADHD?

ADHD is slightly more common in lower socioeconomic status groups.

What cultural factors can influence the diagnosis and treatment of ADHD?

Cultural perceptions of ADHD and access to treatment can vary significantly.

When do signs of ADHD typically become more pronounced?

By ages 3 to 4.

What percentage of children diagnosed with ADHD in elementary school continue to experience symptoms into adolescence?

At least 50%.

What role do genetic influences play in ADHD?

There is a strong genetic component supported by family, twin, and adoption studies.

What environmental factors are associated with an increased risk of ADHD?

Prenatal exposure to substances such as cigarettes, alcohol, and drugs.

What neurobiological findings have been observed in individuals with ADHD?

Changes in neural networks, particularly in gray and white matter, and differences in frontostriatal circuitry.

What neurotransmitters are implicated in ADHD?

Dopamine and norepinephrine, with evidence suggesting a deficiency in their availability.

What is the importance of understanding genetic influences on ADHD?

It can help in developing targeted interventions and treatments.

What is a critical factor for improving long-term outcomes in children with ADHD?

Early intervention.

What challenges do children with ADHD face in social and academic settings?

Co-occurring anxiety and mood disorders can lead to significant challenges.

What strategies can reduce the risk of conduct disorder in children with ADHD?

Promoting positive family interactions and peer support systems.

What is the relationship between ADHD and academic difficulties?

Symptoms often become evident when children start school, leading to increased oppositional behaviors.

What role does awareness of tic disorders play for parents and educators?

It helps provide appropriate support and accommodations for affected children.

What are the primary treatment strategies for ADHD?

A combination of stimulant medication, parent management training, and educational interventions.

Why is early detection and intervention important for children with ADHD?

It is crucial for improving outcomes.

Name two stimulant medications commonly used to treat ADHD.

Dextroamphetamine and methylphenidate (Ritalin).

What is the effect of stimulant medications on children with ADHD?

They can improve attention, impulse control, and reduce disruptive behaviors in about 80% of children.

What role does parent management training play in ADHD treatment?

It equips parents with skills to manage their child's behavior and cope with emotional demands.

What are educational interventions aimed at for children with ADHD?

Setting realistic goals and supporting children in school.

What significant finding did the MTA Study reveal about ADHD treatment?

Stimulant medication was more effective than behavioral treatment alone.

What concerns exist regarding the use of stimulant medications for ADHD?

Concerns about over-prescription and misuse.

What is a key consideration for the safe use of stimulant medications?

Proper supervision and monitoring.

What are some examples of controversial treatments for ADHD?

Allergy treatments and homeopathic remedies, which lack scientific validation.

What is the importance of evidence-based treatments for ADHD?

They should be prioritized over untested treatments that promise quick cures.

What is the purpose of self-assessment in learning about ADHD?

To identify challenges and guide future learning.

What are the three types of specific learning disorders mentioned?

Dyslexia, dyscalculia, and dysgraphia.

What is the role of Individualized Education Programs (IEPs)?

They are tailored educational plans designed to meet the unique needs of students with learning disabilities.

What is multisensory instruction?

An approach that engages multiple senses to enhance learning, particularly effective for students with dyslexia.

How do genetic factors influence language development?

Family history often plays a role in language disorders.

What environmental influences can impact language development?

Socioeconomic status, exposure to language, and educational opportunities.

At what age do infants typically begin to recognize and produce a few words?

By age 1.

What are phonemes in the context of language development?

The smallest units of sound in language that are foundational to language structure.

What happens to infants' ability to distinguish non-native sounds by age 1?

They lose the ability to discriminate non-native sounds.

What is the significance of perceptual maps in language acquisition?

They aid in sound differentiation as children hear phonemes repetitively.

What is the focus of the Response to Intervention (RTI) approach?

Early identification and support for struggling learners.

What did Strauss & Werner advocate for in their 1943 work?

Individualized education, emphasizing that children learn differently.

What historical shift occurred in the 1960s regarding learning disabilities?

The term 'learning disabilities' gained traction, leading to increased support and awareness.

What is the impact of intensive interventions, such as summer treatment programs, on children with ADHD?

They have shown significant improvements in behavior and academic performance.

What is phonological awareness?

The ability to recognize sound-letter relationships, detect rhymes, and manipulate sounds within words, which are critical for literacy.

How do early language issues affect future communication?

They are predictive of future communication and learning disorders, emphasizing the importance of early intervention.

What are common deficits in phonological skills?

Challenges in reading and spelling, as well as difficulties in segmenting phonemes and retrieving names of objects.

What is the DSM-5-TR classification for communication disorders?

It includes language disorder, speech sound disorder, childhood-onset fluency disorder (stuttering), and social (pragmatic) communication disorder.

What characterizes a language disorder?

Difficulties in understanding or producing spoken or written language despite exposure to language stimulation.

What is a speech sound disorder?

It focuses on articulation issues rather than vocabulary knowledge, impacting speech intelligibility and fluency.

What is childhood-onset fluency disorder?

A condition involving stuttering that can significantly interfere with communication and social interactions.

What is social communication disorder?

A classification highlighting challenges in using language for social purposes, affecting peer relationships.

What is the prevalence of language disorders in children?

Approximately 7% of younger school-age children are affected, with a higher prevalence in boys.

What role do genetic factors play in language disorders?

50% to 75% of children with language disorders show a family history of learning disabilities.

How can environmental factors affect language development?

Recurrent middle ear infections can lead to delays in speech and language development.

Why is early intervention important for communication disorders?

Untreated communication difficulties can lead to behavioral and social issues later in life.

What is the main diagnostic feature of Specific Learning Disorder (SLD)?

Difficulty in acquiring key academic skills such as reading, writing, spelling, or mathematics.

What must achievement test scores indicate for SLD diagnosis?

Scores must be at least 1.5 standard deviations below the average for the individual's age and sex.

What are common characteristics of SLD in reading?

Inability to distinguish sounds in spoken words, leading to phonemic awareness difficulties and reading errors.

What is dyslexia?

A pattern of reading difficulties characterized by core deficits in decoding and fluency.

What difficulties characterize SLD with impairment in written expression?

Issues with eye-hand coordination, resulting in poor handwriting quality and less engaging essays.

What are common challenges for children with SLD in mathematics?

Difficulties in number sense, memorization of arithmetic facts, and accurate calculation.

What interventions may help children with writing disorders?

Targeted writing exercises and the use of assistive technology to support writing skills.

What factors influence the decision for treatment in childhood-onset fluency disorder?

Severity of stuttering, the child's social environment, and the impact on self-esteem and peer relationships.

What is the significance of parental involvement in language development?

Parental involvement in language stimulation is crucial for preventing communication disorders.

What is the impact of untreated communication disorders?

They can lead to behavioral and social issues later in life.